Tag Archives: Medicaid
Proposed Rule to Extend and Amend the Exception to Donate Electronic Health Records Items and Services
The Office of Inspector General for the Department of Health and Human Services (OIG) and the Centers for Medicare and Medicaid Services (CMS) published on April 10, 2013 proposed rules to extend and amend the Electronic Health Records (EHR) donation … Continue reading
Auditing the Auditors, Part II: New York State Senate Republicans Request Independent Audit of the OMIG
As a result of a recent Congressional report on New York State’s Medicaid program, the Legislative Gazette has reported that Senate Republican leader Dean Skelos and New York State Senate’s Republican Conference have called for an independent audit of the … Continue reading
Your Tax Dollar At Work: Fighting Medicaid Fraud, Waste, and Abuse in NYC
The New York Post has reported that the New York City Human Resources Administration (“HRA”) spent $15.6 million on Medicaid audits of providers since 2006 and has managed to recover only $11 million in misspent Medicaid funds. The paper also … Continue reading
Auditing the Auditors? Congressional Panel Requests Federal Audit of New York’s Medicaid Program
As a result of a recent Congressional report on New York State’s Medicaid program, a Congressional panel has requested that federal auditors review New York State’s $54 billion Medicaid spending and fraud, waste and abuse oversight programs. The report of … Continue reading
Medicaid Provider Gets His Second Day In Court, Wins $7.7 Million Verdict Against His Accusers
A Brooklyn dentist who alleged that his career was ruined by a New York State Attorney General’s Office Medicaid Fraud Control Unit (MFCU) investigation has won a $7.7 million verdict against two of then-Attorney General Eliot Spitzer’s staff members. According … Continue reading
CMS Issues Section 1135 Waivers for New York and New Jersey
The Centers for Medicare and Medicaid Services (CMS) approved waivers for New York and New Jersey under Section 1135 of the Social Security Act. The waivers ease certain legal requirements on healthcare providers who are serving those impacted by Sandy. … Continue reading
False Claims Act: Payment vs. Participation Regulations
In U.S. ex rel. Williams v. Renal Care Group, Inc. (Case No. 11-5779) (October 5, 2012), the Sixth Circuit Court of Appeals reversed a grant of summary judgment in favor of the United States on two main False Claims Act … Continue reading
OMIG Releases Annual Report for Calendar Year 2011
Today, the New York State Office of the Medicaid Inspector General (“OMIG”) posted its 2011 Annual Report. We will post a detailed analysis in the coming days. In the meantime, the report may be accessed here.
New York State Allegedly Overbilled $15 Billion for State-Operated Facilities for Developmentally Disabled
On May 17, 2012, the U.S. Department of Health and Human Services, Office of Inspector General (OIG) released a report that found Medicaid overpayments to New York State-operated developmental centers. The OIG concluded that, in 2009, State-operated facilities for the developmentally disabled … Continue reading
OMIG Adopts Regulations Concerning Withholding of Medicaid Payments When Fraud Is Alleged
In accordance with federal law, the OMIG has finalized proposed regulatory changes to conform New York State law to federal law regarding the withholding of payments to Medicaid providers when there is a “credible allegation of fraud.” This requirement is … Continue reading
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